胃电图联合多参数对腹部术后胃瘫的预测及其机制研究  

Prediction of gastroparesis after abdominal surgery by electrogastrogram combined with multiple parameters and its mechanism

作　　者：李洋洋 石路[2,3] 杨喆[4] 杨俊[4] 张延猛[2] 朱崟[4] LI Yangyang;SHI Lu;YANG Zhe;YANG Jun;ZHANG Yanmeng;ZHU Yin(Shanghai Jiao Tong University Underwater Engineering Institute Co., Ltd, Shanghai 200231, China;Institute of Underwater Technology, Shanghai Jiao Tong University, Shanghai 200231, China;Shanghai Jiao Tong University-Chiba University International Cooperative Research, Shanghai 200240, China;Department of General Surgery, Shanghai Jiao Tong Universiey Affliated No.6 People 's Hospital, Shanghai 200233, China)

机构地区：[1]上海交大海洋水下工程科学研究院有限公司,上海200231 [2]上海交通大学海洋水下工程科学研究院,上海200231 [3]上海交通大学-千叶大学国际合作研究中心,上海200240 [4]上海交通大学附属第六人民医院普通外科,上海200233

出　　处：《转化医学杂志》2019年第4期240-244,共5页Translational Medicine Journal

基　　金：上海交通大学“医工交叉基金”面上项目(YG2013MS47)

摘　　要：目的通过观察腹部术后患者的体表胃电图(electrogastrogram,EGG)波形变化,结合数字肠胃影像学、上腹部临床症状分度评分以及生化指标等多参数探讨腹部术后胃瘫发生的可能性。方法47例腹部手术患者,根据其术后是否发生胃瘫分为胃瘫组和对照组。比较2组间术前24h、术后72、96和120h体表EGG的差异。同时对47例患者进行数字肠胃影像学检查、上腹部临床症状分度评分以及生化指标检测。结果胃瘫组术后EGG波形中正常胃电慢波消失,呈胃电节律紊乱;胃电节律紊乱患者的数字肠胃影像学报告考虑胃瘫可能;胃瘫组在术后72h的恶心、呕吐和反酸评分均较同阶段的对照组显著升高(均P<0.01);胃瘫组术前24h的血红蛋白和总胆红素含量显著低于对照组(P<0.01和P<0.05),术后24h的白细胞计数显著高于对照组(P<0.01)。结论EGG联合多参数对预测腹部术后胃瘫发生的可能性有一定参考。胃瘫发生可能与患者自控镇痛的耐受性有关。Objective To study the clinical value of electrogastrogram (EGG) in predicting post-operative gastroparesis through EGG, combining with parameters of digital gastrointestinal imaging and clinical symptom score for upper abdominal and biochemical indexes in patients with gastroparesis after abdominal surgery. Methods Forty seven patients who underwent digital gastrectomy were divided in two groups based on the occurrence of gastroparesis. EGG was tested at 24 h pre-operation and 72 h,96 h,120 h post-operation. The digital gastrointestinal imaging, clinical symptom score for upper abdominal and biochemical indexes were recorded before and after operation. Results The normal EGG slow wave disappeared and showed gastric dysrhythmia in gastroparesis group;and the digital gastrointestinal imaging reports indicated that the possibility of gastroparesis in those subjects who showed gastric dysrhythmia;the nausea, vomiting and regurgitation scores of gastroparesis group at 72 h post-operation were significantly increased compared with the control group ( P <0.01);the hemoglobin and total bilirubin of gastroparesis group were significantly lower than control group at 24 h pre-operation ( P <0.01 and P <0.05), and the white blood cell count was significantly higher than control group at 24 h post-operation ( P <0.01). Conclusion EGG combined with multiple parameters had a certain reference to the possibility of prejudging the occurrence of gastroparesis after abdominal surgery,the gastroparesis may be related to the tolerance of patient-controlled analgesia after surgery.

关 键 词：胃瘫 胃电图 数字肠胃影像学 自控镇痛 

分 类 号：R44[医药卫生—诊断学] R656.61[医药卫生—临床医学]